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Early warning scores

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https://www.readbyqxmd.com/read/29229436/a-longitudinal-analysis-of-allostatic-load-among-a-multi-ethnic-sample-of-midlife-women-findings-from-the-study-of-women-s-health-across-the-nation
#1
Laura Chyu, Dawn M Upchurch
OBJECTIVES: We examined longitudinal patterns and sociodemographic correlates of allostatic load (AL), a measure of cumulative biological risk and aging, in a sample of midlife women consisting of non-Hispanic White, African American, Chinese, and Japanese women. METHODS: Longitudinal cohort data from the Study of Women's Health Across the Nation were used to examine AL patterns in midlife women ages 42-53 (n = 1,932). AL measures were created using 10 biomarkers representing cardiovascular, inflammatory, neuroendocrine, and metabolic system functioning...
December 8, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/29216942/-comparison-of-national-early-warning-score-rapid-emergency-medicine-score-and-acute-physiology-and-chronic-health-evaluation-ii-score-for-predicting-outcome-among-emergency-severe-patients
#2
Li Chen, Lipu Deng, Hongmei Zhao, Xiaoying Huang, Xianghua He, Xiangmin Li, Ben Liu, Yongxiang Xie
OBJECTIVE: To analyze the comparation of national early warning score (NEWS), rapid emergency medicine score (REMS) and acute physiology and chronic health evaluation II (APACHE II) score in predicting prognosis of critically ill patients in emergency department (ED). METHODS: A retrospective study was conducted. Critically ill patients, aged > 16 years, hospitalized > 24 hours, and admitted to the ED of Nanhua Hospital Affiliated to South China University from January 2016 to June 2017 were enrolled...
December 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29206360/effect-of-a-children-s-at-home-nursing-team-on-reducing-emergency-admissions
#3
Laura Farnham, Hannah Harwood, Meredith Robertson
This article explores the effect of a children's at-home nursing team, Hospital at Home (H@H), which aimed to reduce demand on acute hospital beds, support families to improve patient experience, and empower parents to care safely for their unwell children and help prevent emergency department (ED) reattendance. Data on demographics and clinical presentation of H@H and ED attendances were collected and compared. A survey measuring parents' confidence in managing their unwell children was also conducted. Of 72 patients treated by the H@H service between May and July 2016, 32 (44%) would have been admitted to hospital from the ED if the H@H service had not existed...
December 5, 2017: Nursing Children and Young People
https://www.readbyqxmd.com/read/29203508/early-warning-scores-for-detecting-deterioration-in-adult-hospital-patients-a-systematic-review-protocol
#4
Stephen Gerry, Jacqueline Birks, Timothy Bonnici, Peter J Watkinson, Shona Kirtley, Gary S Collins
INTRODUCTION: Early warning scores (EWSs) are used extensively to identify patients at risk of deterioration in hospital. Previous systematic reviews suggest that studies which develop EWSs suffer methodological shortcomings and consequently may fail to perform well. The reviews have also identified that few validation studies exist to test whether the scores work in other settings. We will aim to systematically review papers describing the development or validation of EWSs, focusing on methodology, generalisability and reporting...
December 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/29191159/barriers-and-facilitating-factors-related-to-use-of-early-warning-score-among-acute-care-nurses-a-qualitative-study
#5
John Asger Petersen, Lars S Rasmussen, Susan Rydahl-Hansen
BACKGROUND: The early warning score (EWS) was developed to identify deteriorating patients early. It is a track-and-trigger system based on vital signs designed to direct appropriate clinical responses based on the seriousness and nature of the underlying condition. Despite its wide dissemination, serious adverse events still occur, often due to failure among staff on general wards to follow the EWS protocol. The purpose of the study was to determine barriers and facilitating factors related to three aspects of the EWS protocol: 1) adherence to monitoring frequency, 2) call for junior doctors to patients with an elevated EWS, and 3) call for the medical emergency team...
December 1, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29188157/predicting-quality-of-life-changes-in-hemodialysis-patients-using-machine-learning-generation-of-an-early-warning-system
#6
Shoab Saadat, Ayesha Aziz, Hira Ahmad, Hira Imtiaz, Zara S Sohail, Alvina Kazmi, Sanaa Aslam, Naveen Naqvi, Sidra Saadat
Objective To predict changes in the quality of life scores of hemodialysis patients for the coming month and the development of an early warning system using machine learning Methods It was a prospective cohort study (one-month duration) at the dialysis center of a tertiary care hospital in Pakistan. The study started on 1st October 2016. About 78 patients have been enrolled till now. Bachelor of Medicine and Bachelor of Surgery (MBBS) qualified doctors administered a proforma with demographics and the validated Urdu version of World Health Organization Quality Of Life-BREF (WHOQOL-BREF)...
September 25, 2017: Curēus
https://www.readbyqxmd.com/read/29181999/the-effect-of-non-steroidal-anti-inflammatory-drugs-on-severity-of-acute-pancreatitis-and-pancreatic-necrosis
#7
K A Baxter, P H Pucher, D P Berry, H Elberm, M Abu-Hilal, G Marangoni, Zzr Hamady
Introduction Acute pancreatitis (AP) is a common emergency presentation and can be disabling. There is significant morbidity and mortality associated with AP, and it places a considerable burden on the healthcare system. Non-steroidal anti-inflammatory drugs (NSAIDs) have been shown to have a protective effect in some elective contexts. This retrospective study aimed to evaluate the effect of NSAIDs on the course of AP and the severity of the disease. Methods A retrospective analysis was carried out of 324 patients admitted as an emergency with a diagnosis of AP to two UK hospitals...
November 28, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29169912/comparison-of-the-between-the-flags-calling-criteria-to-the-mews-news-and-the-electronic-cardiac-arrest-risk-triage-ecart-score-for-the-identification-of-deteriorating-ward-patients
#8
Malcolm Green, Harvey Lander, Ashley Snyder, Paul Hudson, Matthew Churpek, Dana Edelson
INTRODUCTION: Traditionally, paper based observation charts have been used to identify deteriorating patients, with emerging recent electronic medical records allowing electronic algorithms to risk stratify and help direct the response to deterioration. OBJECTIVE(S): We sought to compare the Between the Flags (BTF) calling criteria to the Modified Early Warning Score (MEWS), National Early Warning Score (NEWS) and electronic Cardiac Arrest Risk Triage (eCART) score...
November 20, 2017: Resuscitation
https://www.readbyqxmd.com/read/29167089/predicting-unplanned-transfers-to-the-intensive-care-unit-a-machine-learning-approach-leveraging-diverse-clinical-elements
#9
Ben Wellner, Joan Grand, Elizabeth Canzone, Matt Coarr, Patrick W Brady, Jeffrey Simmons, Eric Kirkendall, Nathan Dean, Monica Kleinman, Peter Sylvester
BACKGROUND: Early warning scores aid in the detection of pediatric clinical deteriorations but include limited data inputs, rarely include data trends over time, and have limited validation. OBJECTIVE: Machine learning methods that make use of large numbers of predictor variables are now commonplace. This work examines how different types of predictor variables derived from the electronic health record affect the performance of predicting unplanned transfers to the intensive care unit (ICU) at three large children's hospitals...
November 22, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/29167078/implementation-of-pediatric-early-warning-score-adherence-to-guidelines-and-influence-of-context
#10
Ann-Charlotte Almblad, Petra Siltberg, Gunn Engvall, Mats Målqvist
PURPOSE: To describe data of Pediatric Early Warning Score (PEWS) registrations and to evaluate the implementation of PEWS by examining adherence to clinical guidelines based on measured PEWS, and to relate findings to work context. DESIGN AND METHODS: PEWS, as a part of a concept called Early Detection and Treatment-Children (EDT-C) was implemented at three wards at a Children's Hospital in Sweden. Data were collected from the Electronic Patient Record (EPR) retrospectively to assess adherence to guidelines...
October 23, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/29162098/malaria-early-warning-tool-linking-inter-annual-climate-and-malaria-variability-in-northern-guadalcanal-solomon-islands
#11
Jason Smith, Lloyd Tahani, Albino Bobogare, Hugo Bugoro, Francis Otto, George Fafale, David Hiriasa, Adna Kazazic, Grant Beard, Amanda Amjadali, Isabelle Jeanne
BACKGROUND: Malaria control remains a significant challenge in the Solomon Islands. Despite progress made by local malaria control agencies over the past decade, case rates remain high in some areas of the country. Studies from around the world have confirmed important links between climate and malaria transmission. This study focuses on understanding the links between malaria and climate in Guadalcanal, Solomon Islands, with a view towards developing a climate-based monitoring and early warning for periods of enhanced malaria transmission...
November 21, 2017: Malaria Journal
https://www.readbyqxmd.com/read/29150856/defining-sepsis-on-the-wards-results-of-a-multi-centre-point-prevalence-study-comparing-two-sepsis-definitions
#12
T Szakmany, R Pugh, M Kopczynska, R M Lundin, B Sharif, P Morgan, G Ellis, J Abreu, S Kulikouskaya, K Bashir, L Galloway, H Al-Hassan, T Grother, P McNulty, S T Seal, A Cains, M Vreugdenhil, M Abdimalik, N Dennehey, G Evans, J Whitaker, E Beasant, C Hall, M Lazarou, C V Vanderpump, K Harding, L Duffy, A Guerrier Sadler, R Keeling, C Banks, S W Y Ng, S Y Heng, D Thomas, E W Puw, I Otahal, C Battle, O Minik, R A Lyons, J E Hall
Our aim was to prospectively determine the predictive capabilities of SEPSIS-1 and SEPSIS-3 definitions in the emergency departments and general wards. Patients with National Early Warning Score (NEWS) of 3 or above and suspected or proven infection were enrolled over a 24-h period in 13 Welsh hospitals. The primary outcome measure was mortality within 30 days. Out of the 5422 patients screened, 431 fulfilled inclusion criteria and 380 (88%) were recruited. Using the SEPSIS-1 definition, 212 patients had sepsis...
November 17, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29123560/outcomes-in-patients-with-acute-kidney-injury-reviewed-by-critical-care-outreach-what-is-the-role-of-the-national-early-warning-score
#13
Daniel A Potter, Nicholas Wroe, Helen Redhead, Andrew Jp Lewington
Introduction: This study investigated outcomes in critically unwell acute kidney injury patients and the role of the National Early Warning Score and other factors in identifying patients who experience negative outcomes. Methods: Retrospective cohort study investigating 64 patients seen by Critical Care Outreach between November 2014 and February 2015. Mortality at one year was analysed using multivariate regression; all other statistical tests were non-parametric...
November 2017: Journal of the Intensive Care Society
https://www.readbyqxmd.com/read/29122648/early-deterioration-indicator-data-driven-approach-to-detecting-deterioration-in-general-ward
#14
Erina Ghosh, Larry Eshelman, Lin Yang, Eric Carlson, Bill Lord
INTRODUCTION: Early detection of deterioration could facilitate more timely interventions which are instrumental in reducing transfer to higher levels of care such as Intensive Care Unit (ICU) and mortality.(1,2) METHODS AND RESULTS: We developed the Early Deterioration Indicator (EDI) which uses log likelihood risk of vital signs to calculate continuous risk scores. EDI was developed using data from 11864 general ward admissions. To validate EDI, we calculated EDI scores on an additional 2418 general ward stays and compared it to the Modified Early Warning Score (MEWS) and National Early Warning Score (NEWS)...
November 6, 2017: Resuscitation
https://www.readbyqxmd.com/read/29119808/early-warning-and-track-and-trigger-systems-for-newborn-infants-a-review
#15
Nicolay Mortensen, Johan Henrik Augustsson, Jorunn Ulriksen, Unni Tveit Hinna, Georg M Schmölzer, Anne Lee Solevåg
Tools for clinical assessment and escalation of observation and treatment are insufficiently established in the newborn population. We aimed to provide an overview over early warning- and track and trigger systems for newborn infants and performed a nonsystematic review based on a search in Medline and Cinahl until November 2015. Search terms included 'infant, newborn', 'early warning score', and 'track and trigger'. Experts in the field were contacted for identification of unpublished systems. Outcome measures included reference values for physiological parameters including respiratory rate and heart rate, and ways of quantifying the extent of deviations from the reference...
March 2017: Journal of Child Health Care: for Professionals Working with Children in the Hospital and Community
https://www.readbyqxmd.com/read/29114964/chief-physicians-attitudes-towards-early-warning-score-systems-in-switzerland-results-of-a-cross-sectional-survey
#16
Aline Richard, Olga Frank, David Schwappach
RATIONALE, AIMS AND OBJECTIVES: Early warning score systems (EWS-S) have been shown to be valuable tools to recognize otherwise unnoticed clinical deterioration (CDET) of patients. They have been associated with fewer unplanned transfers to the intensive care unit (UTICU) and lower in-hospital mortality. Little is known about their current usage in Switzerland and about the attitudes towards such tools among chief physicians. We aimed to assess the use of EWS-S in Switzerland and the attitudes of chief physicians towards EWS-S depending on previously experienced CDET followed by UTICU, reanimation, or death...
November 8, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29108458/a-fuzzy-logic-based-warning-system-for-patients-classification
#17
Jumanah A Al-Dmour, Assim Sagahyroon, A R Al-Ali, Salah Abusnana
Typically acute deterioration in sick people is preceded by subtle changes in the physiological parameters such as pulse and blood pressure. The Modified Early Warning Score is a scoring system developed to assist hospital staff in gauging these physiological changes and identifying patients in need of urgent medical care to avoid catastrophic deterioration. This work discusses the design and implementation of an equivalent warning system that utilizes fuzzy logic techniques to categorize patients' status. The system is implemented and tested in Rashid Centre for Diabetes and Research in UAE...
November 1, 2017: Health Informatics Journal
https://www.readbyqxmd.com/read/29105064/outcomes-after-cancelled-helicopter-emergency-medical-service-missions-due-to-concurrencies-a-retrospective-cohort-study
#18
Ø Østerås, J-K Heltne, K Tønsager, G Brattebø
BACKGROUND: Appropriate dispatch criteria and helicopter emergency medical service (HEMS) crew decisions are crucial for avoiding over-triage and reducing the number of concurrencies. The aim of the present study was to compare patient outcomes after completed HEMS missions and missions cancelled by the HEMS due to concurrencies. METHODS: Missions cancelled due to concurrencies (AMB group) and completed HEMS missions (HEMS group) in Western Norway from 2004 to 2013 were assessed...
November 3, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29094536/undertaking-an-accurate-and-comprehensive-assessment-of-the-acutely-ill-adult
#19
Paula Mayo
Accurate assessment of the acutely ill adult who has recently been admitted to hospital, or an inpatient whose condition begins to deteriorate, is becoming a required skill for nurses as people live longer and with a variety of complex conditions, and as nursing skills continue to evolve and develop. This article emphasises the importance of undertaking an accurate and comprehensive patient assessment to ensure that management strategies are implemented in a timely manner. The article also considers the importance of the National Early Warning Score (NEWS), which is a 'track-and-trigger' tool designed to identify patients who are at risk of deterioration...
October 18, 2017: Nursing Standard
https://www.readbyqxmd.com/read/29091954/comparison-of-the-mortality-in-emergency-department-sepsis-score-modified-early-warning-score-rapid-emergency-medicine-score-and-rapid-acute-physiology-score-for-predicting-the-outcomes-of-adult-splenic-abscess-patients-in-the-emergency-department
#20
Shang-Kai Hung, Chip-Jin Ng, Chang-Fu Kuo, Zhong Ning Leonard Goh, Lu-Hsiang Huang, Chih-Huang Li, Yi-Ling Chan, Yi-Ming Weng, Joanna Chen-Yeen Seak, Chen-Ken Seak, Chen-June Seak
BACKGROUND: Splenic abscess is rare but has mortality rates as high as 14% even with recent improvements in management. Early and appropriate intervention may improve patient outcomes, yet at present there is no identified method that can predict mortality risk rapidly and accurately for emergency physicians, surgeons, and intensivists to decide on the ideal course of action. OBJECTIVE: This study aims to evaluate the performance of Mortality in Emergency Department Sepsis Score (MEDS), Modified Early Warning Score (MEWS), Rapid Emergency Medicine Score (REMS) and Rapid Acute Physiology Score (RAPS) for predicting the mortality risk of adult splenic abscess patients...
2017: PloS One
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